1. Nipple sparing mastectomy: Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period
- Author
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Alfredo Cirilli, Francesca Catalano, Donato Casella, C. Cabula, Roberto Murgo, Marco Bernini, Massimiliano Bortolini, Vittorio Altomare, L. Regolo, Claudio Amanti, Lorenzo Cecconi, F. Caruso, Caterina Santi, Maria Grazia Lazzaretti, Lorenzo Orzalesi, Graziano Meneghini, Margherita Serra, Manuela Roncella, Stefano Rinaldi, Luigi Cataliotti, Orzalesi, Lorenzo, Casella, Donato, Santi, Caterina, Cecconi, Lorenzo, Murgo, Roberto, Rinaldi, Stefano, Regolo, Lea, Amanti, Claudio, Roncella, Manuela, Serra, Margherita, Meneghini, Graziano, Bortolini, Massimiliano, Altomare, Vittorio, Cabula, Carlo, Catalano, Francesca, Cirilli, Alfredo, Caruso, Francesco, Lazzaretti, Maria Grazia, Cataliotti, Luigi, and Bernini, Marco
- Subjects
Adult ,Nipple-Sparing Mastectomy ,medicine.medical_specialty ,Nipple areola complex necrosi ,locoregional breast recurrences ,Mastectomy, Subcutaneous ,Breast Neoplasms ,030230 surgery ,national registry ,nipple areola complex necrosis ,nipple areola complex recurrences ,nipple sparing mastectomy ,surgery ,Surgical Flaps ,Necrosis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Nipple areola complex recurrence ,medicine ,Humans ,Prospective Studies ,Registries ,Single institution ,Young adult ,Prospective cohort study ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,National registry ,Surgery ,Treatment Outcome ,Italy ,Nipples ,030220 oncology & carcinogenesis ,Female ,National database ,Locoregional breast recurrence ,Neoplasm Recurrence, Local ,business ,Nipple sparing mastectomy - Abstract
Background Nipple sparing mastectomy is deemed surgically and oncologically safe based on a long lasting literature data from reviews of single institution series. This study aims at evaluating surgical and oncological outcomes of NSM on a large multi-institutional scale, by means of the Italian National registry. Methods In July 2011 a panel of Italian specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up schedule guidelines could participate inserting any NSM case performed, retrospectively and prospectively from that moment on. In March 2015 analysis of data was accomplished. Dataset for this study consists of cases performed in the period between January 1st 2009 and December 31st 2014. Results 913 Women were included in the analysis, for a total of 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI utilization increased over time. NSM failure rate, with NAC removal for any reason was 11.5%. NAC necrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes were calculated among primitive EBC cases only: locoregional recurrences rate was 2.9%, NAC recurrence 0.7%. Systemic recurrence rate was 1.0%. Five deaths (0.7%) were registered. Conclusions More than 10% of NSM procedures are prophylactic mastectomies. MRI is gaining more importance over time. Surgical and oncological results show that NSM is effective. This National multicentric analysis enables a comparison of results with no geographical differences and a "safe" state of the art of NSM in Italy.
- Published
- 2016